Although the Cancer Center was approved as a specialized Center, it has, as indicated earlier, continued its efforts to develop and incorporate all of the typical elements of a comprehensive center, albert on a small scale. The reason for incorporating clinical research and outreach acttivities into our existing strengths in epidemiology and basic sciences stems primarily from necessity. Hawaii is an insular state with great distances separating it from the nearest clinical research facility. It must, therefore, depend upon its own local resources to provide the benefits that clinical research affords to cancer patients. Be developing a modest clinical research activity and a statewide outreach program in the Center, we have achieved a definite improvement in cancer care for Hawaii's residents as well as generating useful research data. This improvement is manifested by the availability for the first time of treatment planning in radiation therapy, immunotherapy protocols, Phase II drug therapy, and efficient blood cell component treatment as a few examples.